Monkeypox infection can lead to serious ocular complications, according to the Centers for Disease Control and Prevention (CDC).

In a recent Morbidity and Mortality Weekly Report, the clinical manifestations of ocular monkeypox were described in 5 cases reported in the US between July and September 2022. All 5 patients had experienced prolonged illness, with 4 requiring hospitalization. Treatment initiation was delayed in 2 patients who had HIV-associated immunocompromise. One patient was reported to have experienced vision loss.

Signs and symptoms of ocular monkeypox include vision changes, eye pain, itching, redness, swelling, and foreign body sensation. There may also be lesions near the eye.

Prompt initiation of systemic antiviral therapy in addition to topical trifluridine should be considered in patients with ocular manifestations of monkeypox. In the reported cases, all patients received treatment with tecovirimat and 4 patients received topical trifluridine. According to the authors, initiating empiric treatment may be considered for patients with suspected ocular monkeypox or for those at increased risk of severe complications while Orthopoxvirus/Monkeypox virus PCR test results are pending.

The report also notes the importance of reducing the risk of ocular complications by practicing good hand hygiene. Patients with ocular monkeypox should be instructed to avoid touching their eyes and should also refrain from using contact lenses.

“Ocular monkeypox is a potentially sight-threatening infection,” the authors write. “Urgent ophthalmologic evaluation and the provision of timely medical countermeasures for patients with suspected or confirmed ocular monkeypox might help prevent poor outcomes.”

Reference

Cash-Goldwasser S, Labuda SM, McCormick DW, et al. Ocular monkeypox — United States, July–September 2022. MMWR Morb Mortal Wkly Rep. ePub: October 17, 2022. doi:dx.doi.org/10.15585/mmwr.mm7142e1